Gastrointestinal surgery: gastric MALT lymphoma: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Gastrointestinal surgery: gastric MALT lymphoma

Sample item

A 55-year-old man with dyspepsia has an ulcerated gastric lesion. Biopsy shows lymphoepithelial lesions of marginal zone B cells, Helicobacter pylori is positive, and staging shows disease confined to the stomach wall. What is the first-line treatment?

AHelicobacter pylori eradication therapyBInvolved-site radiotherapyCR-CHOP chemotherapyDTotal gastrectomy with D2 lymphadenectomy

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Helicobacter pylori eradication therapy

Early gastric MALT lymphoma is driven by chronic H. pylori infection and regresses in most patients after eradication therapy. Surgery is not needed for early disease, and radiotherapy or chemotherapy is kept for H. pylori-negative disease, non-responders or advanced stages.

Option by option

A. Helicobacter pylori eradication therapy (correct)
Correct. Eradicating H. pylori removes the antigenic drive and induces remission in most early cases.
B. Involved-site radiotherapy
Radiotherapy is reserved for patients who fail eradication or are H. pylori negative.
C. R-CHOP chemotherapy
R-CHOP is used for high-grade or advanced lymphoma, not for early low-grade MALT disease.
D. Total gastrectomy with D2 lymphadenectomy
Total gastrectomy is not needed because the lymphoma usually responds to eradication.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Helicobacter pylori eradication therapy. Early gastric MALT lymphoma is driven by chronic H.

Why is "Involved-site radiotherapy" not the answer?

Radiotherapy is reserved for patients who fail eradication or are H. pylori negative.

Why is "R-CHOP chemotherapy" not the answer?

R-CHOP is used for high-grade or advanced lymphoma, not for early low-grade MALT disease.

Why is "Total gastrectomy with D2 lymphadenectomy" not the answer?

Total gastrectomy is not needed because the lymphoma usually responds to eradication.

What concept does this question test?

It tests Gastrointestinal surgery: gastric MALT lymphoma in General Surgery. pylori infection and regresses in most patients after eradication therapy. Surgery is not needed for early disease, and radiotherapy or chemotherapy is kept for H. pylori-negative disease, non-responders or advanced stages.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastrointestinal surgery: gastric MALT lymphoma?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.